Wound healing generally progresses through four stages: coagulation, inflammation, cell proliferation and repair of the extracellular matrix (ECM), and finally epithelialization and remodeling to form scar tissue (for reviews, see [1][2][3]). Chronic wound healing, while initially thought to represent an aberration of the normal tissue repair process, is now recognized as being different from normal wound healing. In chronic wounds, remodeling of the ECM is defective, re-epithelialization fails, and the tissue remains inflamed; the wound repair process becomes “stuck” in the inflammatory and/or proliferative stage. Resumption of the process requires identification and removal of the barriers to healing, broadly referred to as wound bed management.
Debridement and subsequent negative pressure wound therapy (NPWT) are crucial components in wound management (for reviews, see [5][6][7]). Current methods of debridement include surgical, mechanical, autolytic, enzymatic, or larval (see [8]). Cost, skills/training, and patient acceptance need to be considered when choosing which method will be most effective. Surgical debridement does not adequately define the border between non-viable and viable tissue and is costly while chemical methods of debridement are slow and require multiple treatments, which requires patient compliance [9].